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Author Topic: questioning my test results  (Read 4588 times)

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Offline shellshocked

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  • Posts: 17
questioning my test results
« on: November 14, 2007, 05:44:13 PM »
Recently, I was diagnosed with HIV. I believe that I may have been exposed to HIV through unprotected anal sex on Aug 11/07. Although the guy did not cum in my ass, there was precum present. I have not had any possible exposures since Aug 11. I was tested on Aug 30, which came back indeterminate. I was tested again on Sept 10, which also came back as indeterminate. On Oct 9, I was tested for the third time. This third test came back positive on the ELISA but only weakly reactive on the Western blot. From the same blood drawn on Oct 9, my CD4 was approximately 700 and my viral load was 1300. I experienced no symptoms of seroconversion illness.

Given that I would have still been in the acute infection stage on Oct 9, it seems strange that my viral load was so low. Not only that, two months after exposure, my Western blot was only weakly reactive. I recently saw an ID specialist who explained that I probably received a low inoculum (i.e. exposed to just a small amount of virus) in precum. He said this would explain why the seroconversion was slower than usual and why the viral load was so low. I'm waiting for further results from viral load testing and antibody testing. In the meantime, my doctor has diagnosed me with HIV. I know that I'll have to wait for more results to get a better picture of what's going on, but I have a few questions:

1. Is a weakly reactive Western blot conclusive enough to diagnosis HIV? I've been reading articles that say that a weakly reactive Western blot is considered indeterminate. Is that true?
2. Is it possible to have such a low viral load during the acute infection stage?

I'm trying to make sense of these test results, which seem fairly atypical in terms of what one would expect to see during the acute infection stage. In 2006, I had serious liver disease (autoimmune hepatitis/cholestasis). These recent tests have been the only HIV testing I've had since being sick with liver disease. Could that bout of liver disease somehow be affecting my test results?

At this point, I'm accepting the doctor's opinion that I'm HIV positive. But am I right to questions these results? And are there other questions that I should be asking at this point?

Offline RapidRod

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Re: questioning my test results
« Reply #1 on: November 14, 2007, 10:01:50 PM »
You need to wait until you get a positive test result and a positive conformation before you consider yourself positive. Indeterminate is neither, positive or negative..

Offline mplsdoubled

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Re: questioning my test results
« Reply #2 on: November 15, 2007, 08:18:36 AM »
If you have a viral load of 1300 (or any number, for that matter) it is my understanding that you have HIV.  HIV negative people do not have a viral load.

It's good that you question and are participating actively in your diagnosis and care but it seems clear to me what your status is.  Try to accept it, get support and live a long, healthy, wonderful life!

Doug

Offline Andy Velez

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Re: questioning my test results
« Reply #3 on: November 15, 2007, 10:21:44 AM »
Shellshocked is a well chosen ID. Getting the news can really knock you over. Accepting the reality of it can be hard. However, I also agree with Doug that you wouldn't have a viral load unless you were positive.

To remove any doubts you have about this, and to help you get on with dealing with it effectively, discuss this with your doctor. If necessary for your own certainty about it re-test if he/she has any similar doubts. 

Keep us posted on how matters are proceeding.

« Last Edit: November 15, 2007, 10:57:51 AM by Andy Velez »
Andy Velez

Offline Matty the Damned

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Re: questioning my test results
« Reply #4 on: November 15, 2007, 11:13:47 PM »
If you have a viral load of 1300 (or any number, for that matter) it is my understanding that you have HIV.  HIV negative people do not have a viral load.

This is not correct. It is possible for people who do not have HIV to return false positive VL test results. This is one reason that VL testing is not approved for diagnostic use.

In fact VL's of under 10,000 in people who have not been confirmed as HIV antibody positive must be viewed with suspicion.

MtD

Offline shellshocked

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  • Posts: 17
Re: questioning my test results
« Reply #5 on: December 01, 2007, 12:08:43 PM »
First, let me say thanks to those of you who have provided input regarding my recent HIV diagnosis. I very much appreciate your helpful and supportive comments.

I'm writing again because I am still confused about the meaning of my test results. I'm trying not to grasp at straws and have come to accept that I'm HIV-positive. However, I feel the need to ask more questions because my results seem somewhat atypical. Let me explain.

In my previous posts, I mentioned that I was likely infected on Aug 11/07, but I no longer believe this to be the case. I recently spoke with the person with whom I had unprotected sex on Aug 11 to notify him of my HIV diagnosis. To my surprise, he said that he was tested at the end of October/07 and that his results were negative. (I have no reason to believe that he's not being untruthful.) This means that it was very unlikely (if not impossible) that I received HIV from him. With the exception of the unprotected anal sex on Aug 11, I have not had any other high risk exposures. I had low risk risk on several occasions in early to mid July, but not unprotected anal. I have not had possible exposures since Aug 11 (i.e. I've been abstaining from sex since then.)

The following is a summary of my recent test results:
Antibody testing
1. Oct 30 - indeterminate (reactive on ELISA, nonreactive on WB)
2. Sept 10 - indeterminate (reactive on ELISA, nonreactive on WB)
3. Oct 9 - positive (reactive on ELISA, weakly reactive on WB)
4. Oct 29 - positive (reactive on ELISA, weakly reactive on WB, nonreactive on P24)

Viral Load/CD4
1. Oct 9 - viral load 1300, CD4 700
2. Oct 29 - viral load 1100, CD4 650

I'm wondering if anyone can help me understand the significance of these results, particularly with respect to the meaning of "weakly reactive" WB. I must have been infected in early July, so why would it be taking so long for the WB to be fully reactive (vs. weakly reactive)? I'm wondering if a weakly reactive WB with a nonreactive P24 is conclusive enough to diagnose HIV. I'm planning to meet with my ID specialist to discuss these results in more detail because my family doctor could not provide much insight into the meaning of these somewhat atypical results. What questions should I be asking my ID specialist in terms of the weakly reactive WB? I know that certain bands must be reactive but I'm not sure what they are. Can anyone shed some light on this for me? Also, what's the significance of the P24 band being nonreactive?

Like I said, I'm trying not to grasp at straws. Since my viral load and CD4 counts also seem unusual in terms of what one might expect to see in an acute infection, I'm all the more perplexed. I'm assuming at this point that I was infected through low risk sex. My ID specialist speculated that I received a "low inoculum", possibly through precum. Would that explain the slow seroconversion and low viral load? The only other thing that comes to mind is that I was very sick with autoimmune hepatitis in February 2006. Could that autoimmune illness somehow be affecting these test results?

I know I've asked a lot of questions.... I've more or less accepted my HIV diagnosis, but I'm still confused and, more than ever, baffled in terms of how I got infected. I'd really appreciate any insights that you can provide.


Offline RapidRod

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Re: questioning my test results
« Reply #6 on: December 02, 2007, 11:00:12 AM »
Until you are confirmed positive you are not positive.

Offline John2038

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Re: questioning my test results
« Reply #7 on: December 03, 2007, 02:41:28 PM »
Hi RapidRod

First at all, I really hops the conclusion will be that you will be definitely negative.

In the case where you should be unfortunately positive, then I believe we our body is reacting almost in a same way.

Here are my counts:

Sept 26 (pm):     509 / 1732 / 18.7%
Nov 7 (am):        381 / 5030 / 17.2%
Nov 12 (pm):      543 / -       / 18.2%
Nov 19 (am):      364 / -       / 24.29%
Nov 20 (pm) :     487 / 3371 / 18.03% (follow-up -pm)
Nov 21 (am):      483 / 3300 / 18.2%
Dec 02 (pm):      608 /PENDING/ 20.49%

I was wondering why the VL was reasonably low, and maybe your post is providing an answer:
He said this would explain why the seroconversion was slower than usual and why the viral load was so low.

I also believe that my seroconversion is finally slower than usual, as the counts are even improving with time, with a minimum in the first 2 weeks of November.

Despite the fact that I'm talking about my case in your thread, my aim is only to mention a somehow similar case.

I hops for anyone else in this case, that such scenario is a good news.
So any others feedback could be instructive.

PS:
My doc also told me that my VL was low. But his comment last week only, was to watch carefully the next labs results to determine if I should start a treatment or not. So nothing totally pink. I suppose only time is the answer.

Offline RapidRod

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  • Posts: 15,288
Re: questioning my test results
« Reply #8 on: December 03, 2007, 04:26:09 PM »
John, I am positive and have been for 23 years.
« Last Edit: December 03, 2007, 04:27:50 PM by RapidRod »

Offline Matty the Damned

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  • Ninja Please
Re: questioning my test results
« Reply #9 on: December 03, 2007, 05:21:54 PM »
Roddles,

I demand you present a WB confirmation of this or restrict yourself AMI and Off Topic. :)

MtD

Offline RapidRod

  • Member
  • Posts: 15,288
Re: questioning my test results
« Reply #10 on: December 03, 2007, 09:58:38 PM »
Roddles,

I demand you present a WB confirmation of this or restrict yourself AMI and Off Topic. :)

MtD

If only it were that easy for me to get a negative test result Matty.  ;)

 


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